目的:探讨大鼠脊髓缺血再灌注损伤过程中诱导型一氧化氮合酶(iNOS)调控脊髓神经元凋亡的具体机制.方法:42只SD大鼠随机分为假手术组(A组,6只).缺血再灌注组(B组,18只)和iNOS抑制组(C组,18只).A组动物麻醉后仅腹腔切开,B组及C组采用腹主动脉阻断法(夹闭腹主动脉1 h后松开,再灌注6.12.24 h)建立脊髓缺血再灌注损伤模型.手术后,A组及B组动物按5 ml/kg腹腔注射5%二甲基亚砜,C组动物按150 mg/kg腹腔注射同等量氨基胍.Tarlov运动功能评分法评估三组大鼠的后肢运动功能.取腰段脊髓组织,透射电镜观察脊髓神经细胞形态学变化,神经元特异性抗体NeuN免疫荧光计算各组脊髓组织中存活神经元数目,Western blot检测iNOS.Bcl-xL/Bcl-2 相关死亡启动因子(Bcl-xL/Bcl-2 associated death promoter,BAD).磷酸化BAD(p-BAD).14-3-3及细胞色素C的表达,免疫共沉淀检测BAD与14-3-3的结合状态.结果:Tarlov运动功能评分显示A组大鼠后肢运动功能无损害,B组和C组大鼠后肢功能明显损害,但C组大鼠后肢功能好于B组(P 〈 0.05).NeuN免疫荧光结果显示B组和C组大鼠脊髓神经元数目明显减少,但C组大鼠脊髓神经元数目多于B组(P 〈 0.05).电镜结果示B组及C组中脊髓组织均有明显凋亡现象,但C组大鼠凋亡程度较轻.Western blot结果表明iNOS和细胞色素C表达量在B组及C组中随再灌注时间延长而增加,但相同再灌注时间C组表达强度明显弱于B组(P 〈 0.05);p-BAD表达量则随着灌注时间延长而下降,但C组中下降程度明显小于B组(P 〈 0.05).免疫共沉淀结果表明:BAD与14-3-3结合力随着再灌注时间的延长在B组和C组中逐渐降低,但是C组程度更慢(P 〈 0.05).结论:脊髓缺血再灌注过程中,iNOS通过促进p-BAD去磷酸化,降低BAD与14-3-3的结合力,进而诱发脊髓神经元的凋亡.
Objective:To investigate the mechanism of iNOS in ischemia-reperfusion injury of rat spinal cord. Methods:Forty-two Sprague-Dawley rats were randomly divided into three different groups: Sham-operated group (n = 6),ischemia-reperfusion group (I/R,n = 18),and iNOS inhibitor group(I/R + AG,n = 18). In sham-operated group,peritoneotomy was performed without abdominal aortic cross-clamping (AACC),however,rats in I/R group and iNOS inhibitor group experienced 1 h AACC followed by 6 h,12 h,24 h reperfusion, respectively. After operation,rats in sham-operated and I/R group received an intraperitoneal injection of the carrier solutions (5 ml/kg of 5% DMSO),while rats in iNOS inhibitor groups received the treatment of AG at the dose of 150 mg/kg (i.p.). We examined the neurological motor function using ‘Tarlov’s score’ at 6 h,12 h and 24 h,alterations of spinal cord neurons morphologically by transmission electron microscopy (TEM). Immunofluerescent staining with anti-NeuN,a specific marker for neurons,was performed to observe the number of surviving neurons in different conditions. The level of iNOS,BAD,p-BAD,14-3-3, and cytochrome C were detected by Western blot;the interaction of BAD and 14-3-3 was determined by coimmunoprecipitation analysis. Results:①The motor functions of the hind limbs of the sham-operated rats were normal. Rats in ischemia-reperfusion group were observed with significant reduce on hind limb movements (P 〈 0.05) in every reperfusion time compared to those in inhibitor group. ②The number of NeuN-positive cells (surviving neurons) in I/R group and iNOS inhibitor group was less than that in sham-operated group,while the number in iNOS inhibitor group was more than that in I/R group (P 〈 0.05). ③In the sham-operated group,no apoptotic neuron was noted. In ischemia-reperfusion group and iNOS inhibitor group,numerous apoptotic neurons could be detected. However the severity of apoptotic neuron in inhibitor group was less than that in I/R g